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Telemedicine for world’s most remote island

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The world’s most remote inhabited island can now access advanced telemedical care, thanks to pro-bono services and support from a high-technology team led by IBM and Beacon Equity Partners. Tristan da Cunha is located more than 1 665 miles west of Cape Town, and is accessible only by a boat trip lasting a week or more. About 270 British citizens call the island home. 

IBM and Beacon Equity Partners today joined Medweb, the University of Pittsburgh Medical Centre (UPMC) and the Government of Tristan da Cunha in announcing the successful implementation of “Project Tristan".
This tested remote medical solution combines medical equipment, satellite communications and remotely supported electronic health-record (EHR) technology, allowing medical experts from anywhere in the world to assist island clinicians in their daily practices with medical diagnoses and emergency support.
Until recently, the island’s only physician, South African medical practitioner, Dr Carel Van der Merwe, has had to rely upon minimal technology and limited medical support. Working from a hospital without so much as its own telephone to provide care for patients, he has often performed life-saving diagnoses and procedures without proper equipment or specialised expertise.
Lacking a communications system that could accept email attachments, help in interpreting X-Rays or EKGs, he has depended on digital images scanned, printed and faxed to specialists thousands of miles away, delaying diagnoses by days. With no airstrip on the island, emergency evacuation or outside medical intervention has been and remains today virtually impossible.
Project Tristan was conceived by Edward Mullen, Chairman of Beacon Equity Partners, and Paul Grundy, MD, MPH, and IBM’s Director of Healthcare Technology and Strategic Initiatives, as a way to honor the memory of a close friend, Thomas Wiese.
It was implemented with the guidance and support of UPMC, as well as of Dr Richard Bakalar, Chief Medical Officer for IBM, who also established the Navy’s first integrated Telemedicine Office at the National Naval Medical Center in Bethesda, MD, prior to joining IBM. Dr Bakalar is also President of the American Telemedicine Association.
Project Tristan, which is based on open standards and runs on the Linux Operating System, is expected to greatly enhance the island’s level of medical care and standard of living.
The island’s physician is now able to electronically capture and share medical data and information, including X-Rays and EKGs as well as pulmonary function evaluations and video camera examinations with physician consultants.  Satellite communications will enable clinicians to provide real-time diagnostic advice and suggested treatments to the attending physician.
“The ability to share medical data quickly and easily will be a life saver for our residents,” says Dr Van der Merwe. “By joining forces, IBM, Beacon Equity Partners, Medweb and UPMC have not only created the capability to bring critical, patient-centric care to our remote island, but also to other distant locations around the world – on land or sea – that require constant connection to expert medical resources.”
Paul Grundy, MD, MPH, IBM’s executive sponsor for Project Tristan and Director of IBM’s Healthcare Technology and Strategic Initiatives, says: “Connecting the most remote inhabited spot on the face of the earth, Tristan da Cunha, to advanced medical care in real time and over the Internet is proof that the world is really flat.
"This is a big step towards providing everyone access to centres of healthcare excellence regardless of geographical location. It’s now possible to monitor a patient’s heart and remotely change the setting on a pacemaker or make a complex fracture diagnoses over a satellite Internet connection – even in an environment where the closest advanced care via a ship would otherwise have taken a week to reach the island and another to return to the mainland for care.”